If your doctor is a non participating Medicare provider, you may notice an additional amount you are responsible for paying.
– One way to avoid excess charges if you have nonparticipating providers is with a Medicare plan G. This article will explain what Medicare plan G is, who qualifies for it, how to get it, and its cost.
What is the Difference Between a Participating and a Nonparticipating Provider?
Medicare Assignment is also known as the Medicare-approved rate for services provided by participating providers. In a nonparticipating provider arrangement, insurance is accepted, but Medicare Assignment is not accepted and, consequently, Medicare’s rate is not accepted.
Due to their refusal to accept Medicare Assignment, they can charge you extra for Medicare Part B services.
Agent Tip
You can search for participating providers on Medicare.gov
What are Part B Excess Charges?
If you have a Medicare-approved service completed by a nonparticipating provider, they can charge you 15% above what Medicare allows. This charge is the excess charge. Some Medigap plans pay these for you, and some do not. If you’d like to avoid them, you’ll want to look into the plans that pay for you so that you don’t have to worry about them.
Learn more about Part B excess charges here.
Medicare Supplement Plans Help Cover the Costs of Your Medical Care
Most people are familiar with Medicare Part A, but few know how it works.
Medicare Part A will cover your hospital care and is free to all eligible beneficiaries, but you’ll be responsible for the deductible. After you meet this requirement, Medicare will take over. However, because it doesn’t cover everything, a Medicare Supplement plan can help you pay for items that aren’t included in the program.
This includes any further costs involved after your deductible was met or anything that falls outside of what Original Medicare provides coverage for.
There are ten standardized plans that provide different types of benefits so be sure to choose one based on your needs. While there are some out-of-pocket expenses for services covered by a plan, they will save you a lot of money in comparison to paying for everything yourself.
How Excess Charges are Covered Under the Most Popular Supplement Plans
In 2024, Medicare Plan G will be one of the most popular plans. Medicare Plan G provides comprehensive coverage at a very affordable price. Under Plan G, all costs after Original Medicare are covered except the $240 annual deductible under Part B. Due to Plan G’s 100% coverage of Part B excess charges, you do not need to worry whether a doctor is a participating or nonparticipating provider.
In 2024, Plan N will be the other most popular Medicare Supplement plan. Plan N does not cover the Part B deductible, as well as a few other services. When you enroll in Plan N, your office visit copays will be up to $20 and your emergency room copays will be up to $50. In addition, Plan N does not cover excess charges on Part B services, so you are responsible for those as well if you visit a nonparticipating provider.
Get in touch with a Medicare expert today
You can compare plans at Bluewave Insurance and find a plan in your area that is cost-effective and covers the services you need. As well as helping you once your policy is effective, we’ll also assist you if you encounter questionable charges. We look forward to speaking with you!
Alex Wender is the founder and CEO of Bluewave Insurance. He has been blogging about Medicare-related topics since 2010. Since then, he and his agency have helped thousands of people across the country choose the right Medicare to fit their needs.
